Provider Demographics
NPI:1578634374
Name:SIMON-FLEISCHER, SUSAN (MSW)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:SIMON-FLEISCHER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2500
Mailing Address - Country:US
Mailing Address - Phone:973-535-3626
Mailing Address - Fax:
Practice Address - Street 1:205 RIDGEDALE AVE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1349
Practice Address - Country:US
Practice Address - Phone:973-535-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC013379001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical